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The effect of oral probiotics on response to vaccination in older adults: a systematic review of randomised controlled trials

The effect of oral probiotics on response to vaccination in older adults: a systematic review of randomised controlled trials
The effect of oral probiotics on response to vaccination in older adults: a systematic review of randomised controlled trials

This systematic review evaluated the impact of oral probiotics on the immune response to vaccination in older people. A literature search was performed in three electronic databases up to January 2023. Randomised controlled trials (RCTs) conducted in older people (age ≥ 60 years) investigating oral probiotics and vaccine response outcomes were included. Characteristics and outcome data of the included studies were extracted and analysed and study quality was assessed using the Cochrane Risk of Bias Tool for randomised trials. Ten RCTs involving 1,560 participants, reported in 9 papers, were included. Nine studies involved the seasonal influenza vaccine and one a COVID-19 vaccine. All studies used lactobacilli, some in combination with bifidobacteria. Studies reported outcomes including anti-vaccine antibody titres or concentrations, seroconversion and seroprotection. When comparing antibody titres, seroprotection rate and seroconversion rate between probiotic and placebo groups expressed as a response ratio, the weighted mean values were 1.29, 1.16 and 2.00, respectively. Meta-analysis showed that probiotics increase seroconversion rates to all three strains of the seasonal influenza vaccine: odds ratio (95% confidence interval) 2.74 (1.31, 5.70; P = 0.007) for the H1N1 strain; 1.90 (1.04, 3.44; P = 0.04) for the H3N2 strain; 1.72 (1.05, 2.80; P = 0.03) for the B strain. There was a low level of heterogeneity in these findings. Several studies were at high risk of bias due to missing outcome data. Lactobacilli may improve the vaccine response, but further research is needed to be more certain of this.

immunity, older people, probiotic, systematic review, vaccine response
0002-0729
ii70-ii79
Tunc, Hediye Arioz
ab5a91a2-e9fe-43ff-87f0-f248df7a4d86
Childs, Caroline E.
ea17ccc1-2eac-4f67-96c7-a0c4d9dfd9c5
Swann, Jonathan R.
7c11a66b-f4b8-4dbf-aa17-ad8b0561b85c
Calder, Philip C.
1797e54f-378e-4dcb-80a4-3e30018f07a6
Tunc, Hediye Arioz
ab5a91a2-e9fe-43ff-87f0-f248df7a4d86
Childs, Caroline E.
ea17ccc1-2eac-4f67-96c7-a0c4d9dfd9c5
Swann, Jonathan R.
7c11a66b-f4b8-4dbf-aa17-ad8b0561b85c
Calder, Philip C.
1797e54f-378e-4dcb-80a4-3e30018f07a6

Tunc, Hediye Arioz, Childs, Caroline E., Swann, Jonathan R. and Calder, Philip C. (2024) The effect of oral probiotics on response to vaccination in older adults: a systematic review of randomised controlled trials. Age and Ageing, 53, ii70-ii79. (doi:10.1093/ageing/afae033).

Record type: Review

Abstract

This systematic review evaluated the impact of oral probiotics on the immune response to vaccination in older people. A literature search was performed in three electronic databases up to January 2023. Randomised controlled trials (RCTs) conducted in older people (age ≥ 60 years) investigating oral probiotics and vaccine response outcomes were included. Characteristics and outcome data of the included studies were extracted and analysed and study quality was assessed using the Cochrane Risk of Bias Tool for randomised trials. Ten RCTs involving 1,560 participants, reported in 9 papers, were included. Nine studies involved the seasonal influenza vaccine and one a COVID-19 vaccine. All studies used lactobacilli, some in combination with bifidobacteria. Studies reported outcomes including anti-vaccine antibody titres or concentrations, seroconversion and seroprotection. When comparing antibody titres, seroprotection rate and seroconversion rate between probiotic and placebo groups expressed as a response ratio, the weighted mean values were 1.29, 1.16 and 2.00, respectively. Meta-analysis showed that probiotics increase seroconversion rates to all three strains of the seasonal influenza vaccine: odds ratio (95% confidence interval) 2.74 (1.31, 5.70; P = 0.007) for the H1N1 strain; 1.90 (1.04, 3.44; P = 0.04) for the H3N2 strain; 1.72 (1.05, 2.80; P = 0.03) for the B strain. There was a low level of heterogeneity in these findings. Several studies were at high risk of bias due to missing outcome data. Lactobacilli may improve the vaccine response, but further research is needed to be more certain of this.

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Arioz Tunc et al._Manuscript_Revised for submission_Clean Version - Accepted Manuscript
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Accepted/In Press date: 2 February 2024
Published date: 1 May 2024
Keywords: immunity, older people, probiotic, systematic review, vaccine response

Identifiers

Local EPrints ID: 486755
URI: http://eprints.soton.ac.uk/id/eprint/486755
ISSN: 0002-0729
PURE UUID: 8a4c85a4-3143-4d30-b79d-7cdc90587dec
ORCID for Hediye Arioz Tunc: ORCID iD orcid.org/0000-0002-3452-7690
ORCID for Caroline E. Childs: ORCID iD orcid.org/0000-0001-6832-224X
ORCID for Jonathan R. Swann: ORCID iD orcid.org/0000-0002-6485-4529
ORCID for Philip C. Calder: ORCID iD orcid.org/0000-0002-6038-710X

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Date deposited: 06 Feb 2024 17:30
Last modified: 15 Oct 2024 02:05

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Author: Hediye Arioz Tunc ORCID iD

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